Purpose: A case with no clinical signs of a breast mass and an macroscopic evidence of Paget’s disease in the mastectomy material is reported.
Material Method: Although eczematous nipple changes for 24 months were present in sixty year old woman, clinically, a palpable breast mass was not determined. After the incisional biopsy of right nipple was reported as Paget’s disease of the breast, modified radical mastectomy was performed. The tissue sampling was appropriately done in macroscopical examination. After the routine tissue processing and staining procedure, the tissue sections were examined under the light microscopy.
Findings: In macroscopical examination of the right mastectomy material, any occupied lesion was noted. When macroscopical examination was continued by thin slices, punctuated calcifications in a 10x9 millimeter area were noted in upper outside quadrant.
Two separate foci of ductal carcinoma in situ in both of upper outside and lower inner quadrants were determined in microscopical examination. Metastatic lymph node was not present in axillary dissection material.
Result: An underlying breast mass can not present in Paget’s disease of the breast or the mass can be too small to determine. Furthermore, the tumoral focus can also be in character of ductal carcinoma in situ. For this reason, when the mastectomy materials of the cases of Paget’s disease of the breast are evaluated, it should be kept in mind that only ductal carcinoma in situ focus could be found in mastectomy material as the underlying tumoral lesion in Paget’s disease of the breast.
Key Words: Mammary Paget’s disease, Ductal carcinoma in situ, Paget’s cells
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